Acta Neuropathologica最新文献

Primary age-related tauopathy (PART) has been associated with milder degrees of cognitive impairment, but the role of PART-related tangles, from the hippocampus, nearby inferior temporal neocortex, and the role of co-existing pathologies on cognitive decline are underappreciated. We used three harmonized community-based clinicopathologic studies to investigate the association of regional distributions of tangles and co-existing pathologies with cognitive decline. At autopsy, PART was defined by a Braak NFT stage of I–IV in the absence or with limited amyloid-β (Thal ≤ 2). Tau tangle density from the hippocampus and inferior temporal cortex were evaluated by AT8-immunohistochemistry. Other brain pathologies (LATE-NC, Lewy bodies (LBs), and vascular pathologies) were also evaluated. Linear mixed effect models were employed to examine the associations between regional tau tangles and other brain pathologies with decline in global cognition and 5 cognitive domains. Among 1,859 participants, 527 (28%) had neuropathologically confirmed PART: 385 had possible PART and 142 had definite PART, with an average age at death of 88 ± 6.9 years and 63% being female. Nearly all PART participants (N = 524) had hippocampal tangles and 449 also exhibited tangles in the inferior temporal neocortex. After controlling demographics and other brain pathologies, hippocampal and inferior temporal neocortical tangle burden were each associated with decline in global cognition and episodic memory; however, the effect of inferior temporal neocortical tangles on decline was 3.2 times stronger than that of hippocampal tangles. In further analyses, when included together in the same model, only the association of inferior temporal neocortical tangle burden persisted. However, using Braak staging alone, we did not find a clinical–pathological relationship between tangles and cognitive decline. Additionally, LATE-NC, LBs, atherosclerosis, and cerebral infarcts were each independently associated with cognitive decline. Our data also indicated that LATE-NC may have stronger impact on cognitive decline in PART than tau tangles. Overall, this study provides evidence that both extension of tangles to the nearby neocortex, specifically the inferior temporal, along with other co-pathologies, particularly LATE-NC, play a key role in cognitive decline in PART.

Extracellular amyloid plaques, the pathognomonic hallmark of Alzheimer’s disease (AD), are also observed in cognitively unimpaired subjects in the preclinical stages. Progressive accumulation of fibrillar amyloid-β (Aβ) as plaques and perivascular deposits occur two decades before clinical onset, making Aβ a long-lived peptide. To characterize the amyloid plaques biochemically, both the Aβ-load as well the post-translational modifications (PTMs) could serve as markers for distinguishing the pre-clinical stage compared to later prodromal and clinical stages of AD. Recently, we described the presence of extensive isomerization of the Aβ N-terminus in AD post-mortem brains that is significantly increased compared to the age-matched non-AD control brains with Aβ aggregates. In this report, we performed Lys-N enzymatic digestion followed by mass spectrometry-based quantitative analysis of the most common PTMs associated with plaque Aβ. We focused on pyroglutamation (pGlu3), citrullination (cit5), N-terminal truncation (Aβ_4-x), C-terminal isoforms (Aβ_x-42 and Aβ_x-40), and isomerization of aspartic acid residues (Asp-1 and Asp-7) in postmortem human brain tissue from pathologically negative (no Aβ plaques) controls (n = 23), controls with Aβ plaques (n = 35), Parkinson’s disease (PD) with (n = 28) and without Aβ accumulation/plaques (n = 30) and symptomatic AD (n = 60). The AD cases contained statistically significant amounts of Asp-1 and Asp-7 isomerized Aβ (~ 90%) compared to controls (preclinical AD) and PD brains with fibrillar Aβ aggregates/deposits. We find that the ratio of isomerized N-terminus Aβ (Aβ_1-x) species in the brain detergent soluble pool differentiates older fibrillar Aβ deposits in symptomatic AD brain compared to Aβ deposits detected in preclinical AD and PD. Citrullinated pGlu3-Aβ was increased only in symptomatic AD, highlighting this Aβ PTM is a unique feature of parenchymal plaques in advanced AD. Our results have implications for early therapeutic targeting of these modified species as well as potential for better biofluid biomarker development for drug efficacy monitoring.

ATP10B, a transmembrane lipid flippase located in late endosomes and lysosomes, facilitates the export of glucosylceramide and phosphatidylcholine by coupling this process to ATP hydrolysis. Recently, loss-of-function mutations in the ATP10B gene have been identified in Parkinson’s disease patients, pointing to ATP10B as a candidate genetic risk factor. Previous studies have shown compromised lysosomal functionality upon ATP10B knockdown in human cell lines and primary cortical neurons. To investigate the role of ATP10B in Parkinson’s disease neuropathology, specifically in the nigrostriatal dopaminergic system, we induced ATP10B knockdown specifically in substantia nigra pars compacta neurons of rats using viral vector technology. Additionally, midbrain neuronal cultures derived from ATP10B knock-out human induced pluripotent stem cells clones were used to study the impact of ATP10B loss in dopaminergic neurons in a more translational model. Atp10b knockdown in rat brain induced parkinsonian motor deficits, and longitudinal striatal dopamine transporter ¹⁸F-FE-PE2I PET imaging revealed a progressive decrease in binding potential. Immunohistochemical analysis conducted one year post-injection confirmed the loss of dopaminergic terminals in the striatum, alongside a loss of dopaminergic neurons in the substantia nigra pars compacta. The expression of LAMP1, LAMP2a, cathepsin B and glucocerebrosidase was studied in dopaminergic neurons. A decrease in lysosomal numbers and an increase in lysosomal volume were observed more consistently in one of the knockdown constructs. The vulnerability of dopaminergic neurons to ATP10B loss-of-function was also observed in midbrain neuronal cultures derived from ATP10B knock-out human induced pluripotent stem cells clones, which showed a significant reduction in TH-positive neurons. Taken together, our findings demonstrate that ATP10B depletion detrimentally impacts the viability of dopaminergic neurons both in vivo and in vitro. Moreover, a broader impact on the functionality of the nigrostriatal pathway was evidenced as rats with Atp10b knockdown exhibited motor impairments similar to those observed in Parkinson’s disease patients.

Translocator protein 18 kDA (TSPO) imaging using positron emission tomography (PET) is widely used to assess neuroinflammation in Alzheimer’s disease (AD). However, the significance of the increase in brain TSPO levels in AD pathophysiology is not known. Here, we show that in the 5XFAD transgenic mouse model, brain TSPO levels increase in an age-, brain region-, and sex-dependent fashion. TSPO levels were first increased in the subiculum at 1.5 months of age in male and female 5XFAD mice compared to wildtype mice. The TSPO increase in the subiculum of 1.5-month 5XFAD mice coincided with the appearance of Aβ aggregation and increased serum Aβ_1-42/Aβ_1-40 ratio which occurred prior to increased serum neurofilament light chain (Nfl) levels and well before cognitive function deficits. We also discovered that the brain TSPO increase was driven by an expansion of activated microglia in contact with Aβ-plaques, that also expressed higher TSPO levels per microglia than microglia not in contact with plaques. While overall, astrocytes were highly activated, the increased TSPO signal in the 5XFAD mouse brain did not increase in astrocytes. We also compared the 5XFAD mouse findings to postmortem human brain tissue from early-onset autosomal-dominant Presenilin 1 (PSEN1)-E280A mutation AD cases. The results in PSEN1-E280A cases confirmed the 5XFAD mouse findings relevant to increased TSPO levels and an increase in TSPO per microglia contacting Aβ-plaques. In summary, TSPO is an early biomarker of neuroinflammation in the AD brain that first increases in the subiculum simultaneously with increased Aβ aggregation and serum Aβ_1-42/Aβ_1-40 ratio. The increased TSPO response in the 5XFAD mouse brain and in the brain from PSEN1-E280A mutation AD cases reflects Aβ-plaque-associated microglia with a high TSPO content. This microglia subtype is likely to promote the progression of AD pathology, neurodegeneration, and cognitive decline and their high TSPO content may serve as a target for TSPO ligand-based therapy.

Cerebral amyloid angiopathy (CAA) is a cerebrovascular disorder marked by amyloid-β (Aβ) deposition in blood vessel walls, leading to hemorrhage and recurring stroke. Despite significant overlap with Alzheimer’s disease (AD) through shared Aβ pathology, the specific structural characteristics of Aβ aggregates in CAA and their variations between stages of disease severity are yet to be fully understood. Traditional approaches relying on brain-derived fibrils can potentially overlook the polymorphic heterogeneity and chemical associations within vascular amyloids. This study utilizes sub-diffraction, label-free optical photothermal infrared (O-PTIR) spectroscopic imaging to directly probe the chemical structure and heterogeneity of vascular amyloid aggregates within human brain tissues across different CAA stages. Our results demonstrate a clear increase in β-sheet content within vascular Aβ deposits corresponding to disease progression. Crucially, we identify a significant presence of antiparallel β-sheet structures, particularly prevalent in moderate/severe CAA. The abundance of antiparallel structures correlates strongly with co-localized lipids, implicating a lipid-mediated aggregation mechanism. We substantiate the ex-vivo observations using nanoscale AFM-IR spectroscopy and demonstrate that Aβ40 aggregated in-vitro with brain-derived lipids adopts antiparallel structural distributions mirroring those found in CAA vascular lesions. This work provides critical insights into the structural distributions of Aβ aggregates in CAA, highlighting the presence of polymorphs typically associated with transient intermediates, which may lead to alternate mechanisms for neurotoxicity.